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Complaint and Investigation Request

  1. Complaint and Investigation Request
  2. Complaint and Investigation Request 112822_Page_2
  3. I CERTIFY (OR DECLARE) THAT THE FOREGOING IS TRUE AND CORRECT.
  4. FOR OFFICE USE ONLY
  5. Intake Initials
  6. Date Recieved
  7. Case Number
  8. Leave This Blank:

  9. This field is not part of the form submission.